ONLINE LOAN APPLICATION


In order to comply with the USA Patriot Act, PortAlliance is required to verify the identity of members applying for and opening new accounts or services with the credit union. Information that we are required to obtain include name, mailing and residential addresses, tax identification number, date of birth and a copy of government issued photo ID. Additional data may be gathered depending on the type of account opened. Data on existing members will be gathered as they open or use additional services offered by the credit union. The Act requires us to maintain and periodically update records of identity verification.

How to Apply:

  • Please fill out this application completely. an incomplete application may delay processing.
  • Use the Submit button at the bottom to securely forward it to us, or if you prefer you may print the form and drop it off, mail it, or fax it to PortAlliance Federal Credit Union for processing.
  • You'll hear back from us as soon as possible. We look forward to helping you with your lending needs!

    * - denotes required fields

Individual Credit - You must complete the Applicant section about yourself and theCo-Applicant section about your spouse, if any of the following are true:

  • you live in or the property pledged as collateral is located in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI), or
  • your spouse will use the account, or
  • you are relying on your spouse's income as a basis for repayment.

Joint Credit - If you are applying with another person, complete the Applicant and Co-Applicant sections.

Loan Information
*Will there be a co-applicant on this loan application? 
Yes or No 
*Amount requested 
*Purpose          
*Collateral
*Repayment
Personal Information
*Complete for joint credit, secured credit or if you live in a community property state:
Married   Separated   Unmarried (single/divorced/widowed)
*First Name:
Middle Initial:
*Last Name:
*Social Security Number: - -
*Birthdate (xx/xx/xxxx)
*State Issued ID:
*Issued Date:
*Expiration Date:
*Home Address:
*City:
*State:
*Zip:
*How Long? years
*Housing Type?
*Monthly Payment?
If you've lived at your current address less than 2 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:
*Email Address:
Home Phone Number: () -
Cell Phone Number: () -
Employment Information
*Start Date: (xx/xx/xxxx)
*Hours Worked per Week:
*Work Phone Number: () -
*Job Title:
*Employer name:
*Address:
*City:
*State:
*Zip:
Income & Asset Information
*Employment Income (before taxes): per
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Other income source
References
Nearest relative Not Living With You
*First Name:
*Last Name:
Relationship:
* -- ext.
Address 1:
Address 2:
City:
State:
*Zip: -

*First Name:
*Last Name:
Relationship:
* -- ext.
Address 1:
Address 2:
City:
State:
*Zip: -
Any comments or questions you may have for us?

By submitting this application, I/We certify that this information has been supplied truthfully, accurately and voluntarily, and therefore authorize PortAlliance Federal Credit Union. to investigate our creditworthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means for consideration for the loan applied for, or for any other services offered.  This application does not constitute a contract for the extension of credit.  

Thank You.  Upon receipt of this application, someone at PortAlliance Federal Credit Union will review your information and get back to you to extend credit, with additional questions or to request  further information. We appreciate this opportunity to be your financial partner.

If this is a single application you may submit now!

 

Co-Applicant Information

Complete the required fields below ONLY if there is a co-applicant.
*Complete for joint credit, secured credit or if you live in a community property state:
Married   Separated   Unmarried (single/divorced/windowed)
*First Name:
Middle Initial:
*Last Name:
*Social Security Number: - -
*Birthdate (xx/xx/xxxx)
*Home Address:
*City:
*State:
*Zip:
How Long? years
Housing Type?
Monthly Payment?
If you've lived at your current address less than 2 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:
*Email Address:
Home Phone Number: () -
Employment Information
*Start Date: (xx/xx/xxxx)
*Hours Worked per Week:
*Work Phone Number: () -
*Job Title:
*Employer name:
*Address:
*City:
*State:
*Zip:
Income & Asset Information
*Employment Income (before taxes): per
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Other income source
Any comments or questions you may have for us?

By submitting this application, I/We certify that this information has been supplied truthfully, accurately and voluntarily, and therefore authorize PortAlliance Federal Credit Union. to investigate our creditworthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means for consideration for the loan applied for, or for any other services offered.  This application does not constitute a contract for the extension of credit.  

Thank You.  Upon receipt of this application, someone at PortAlliance Federal Credit Union will review your information and get back to you to extend credit, with additional questions or to request  further information. We appreciate this opportunity to be your financial partner.